Department of Endoscopy Center, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
Surg Endosc. 2023 Jul;37(7):5094-5100. doi: 10.1007/s00464-023-09991-y. Epub 2023 Mar 15.
Magnifying endoscopy is advantageous in detecting precancerous lesions. Our study aimed to clarify its ability to detect easily missed neoplastic lesions on the upper gastrointestinal tract. A retrospective analysis of clinical, endoscopic, and pathological data of cases undergoing gastroscopy was performed using magnifying and routine endoscopy. The detection rates of overall lesions, the ability to identify flat-type neoplastic lesions, and the easily missed neoplastic lesions were compared between the two groups. Endoscopic data from 32,367 patients was analyzed in this study. The use of magnifying endoscopy was an independent factor in identifying flat lesions (OR 2.236, 95% CI 1.969-2.540, p < 0.001), particularly type IIb lesions (OR 3.117, 95% CI 2.333-4.165, p < 0.001). For neoplastic lesions, magnifying endoscopy was also identified as having better sensitivity than routine endoscopy (sensitivity, 90.4% vs. 78.9%, p < 0.001). Similarly, magnifying endoscopy was an independent factor for identifying flat lesions (OR 2.927, 95% CI 2.365-3.621, p < 0.001), especially type IIc lesions (OR 4.415, 95% CI 3.076-6.339, p < 0.001). Magnifying endoscopy was also identified as having superior sensitivity (44.7% vs. 13.3%, p = 0.034) for early cancerous lesions. Compared to routine endoscopy, magnification endoscopy is advantageous in detecting and identifying neoplastic lesions in the upper gastrointestinal tract, especially flat neoplastic lesions and early cancers.
放大内镜有利于发现癌前病变。本研究旨在阐明其在上消化道检测易漏诊的肿瘤性病变的能力。我们对接受胃镜检查的患者的临床、内镜和病理资料进行了回顾性分析，分别采用放大内镜和常规内镜进行检查。比较两组的总体病变检出率、识别平坦型肿瘤性病变的能力和易漏诊的肿瘤性病变检出率。本研究共分析了 32367 例患者的内镜资料。使用放大内镜是识别平坦病变（OR 2.236，95%CI 1.969-2.540，p<0.001），特别是Ⅱ b 型病变（OR 3.117，95%CI 2.333-4.165，p<0.001）的独立因素。对于肿瘤性病变，放大内镜的敏感性也优于常规内镜（敏感性分别为 90.4%和 78.9%，p<0.001）。同样，放大内镜是识别平坦病变（OR 2.927，95%CI 2.365-3.621，p<0.001），特别是Ⅱ c 型病变（OR 4.415，95%CI 3.076-6.339，p<0.001）的独立因素。放大内镜还被认为对早期癌性病变具有更高的敏感性（44.7%比 13.3%，p=0.034）。与常规内镜相比，放大内镜在上消化道肿瘤性病变的检测和识别方面具有优势，尤其是对平坦型肿瘤性病变和早期癌症。
